# STATE STREET PHARMACY LTC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STATE STREET PHARMACY AND WELLNESS CENTER INC
- **Other names:** State Street Pharmacy LTC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588422158
- **Legal business name:** STATE STREET PHARMACY AND WELLNESS CENTER INC
- **Authorized official:** ADAM ZOVISHLACK (PRESIDENT/OWNER)
- **Authorized official phone:** (989) 672-3500

## Contact information

- **Practice address:** 192 N STATE ST, CARO, MI 48723-1550
- **Practice address phone:** (989) 672-3500
- **Practice address fax:** (989) 672-3555
- **Mailing address:** 192 N STATE ST, CARO, MI 48723-1550
- **Mailing address phone:** (989) 672-3500
- **Mailing address fax:** (989) 672-3555

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2024
- **Last updated:** 03/08/2024